Ntalouka M P, Pantazopoulos I, Brotis A G, Pagonis A, Vatsiou I, Chatzis A, Rarras C N, Kotsi P, Gourgoulianis K I, Arnaoutoglou E M
Department of Anesthesiology, Faculty of Medicine, School of Health Sciences, University Hospital of Larissa, University of Thessaly, Larissa, Greece.
Department of Emergency Medicine, Faculty of Medicine, School of Health Sciences, University Hospital of Larissa, University of Thessaly, Larissa, Greece.
Hippokratia. 2022 Apr-Jun;26(2):70-77.
BACKGROUND/AIM: Simple inflammatory biomarkers, such as neutrophil to lymphocyte ratio (NLR), could serve as prognosis indicators in patients with Coronavirus disease 2019 (COVID-19). The utility of on-admission inflammatory biomarkers in predicting outcomes was investigated in patients suffering from severe COVID-19 infection.
We performed a retrospective study to assess the role of white blood count (WBC), neutrophils (N), lymphocyte (L), platelets (PLTs), C-reactive protein (CRP), reverse transcription polymerase chain reaction (RT-PCR), NLR (N/L), PLR (P/L), dv (derived variation of)-NLR (N/WBC-L), LNR (L/N), dv (derived variation of)-LNR (L/WBC-N), and CLR (CRP/L), in predicting the need for high-flow nasal cannula (HFNC) use, admission to Intensive Care Unit (ICU), and death in adult patients with severe COVID-19 admitted to the Department of Respiratory Medicine from April to September 2021.
One hundred and fifteen patients (60 % males) with a mean age of 57.7 ± 16.3 years were included. Thirty-seven patients (32.2 %) required escalation with HFNC, eight patients (7 %) were admitted to the ICU, and nine patients (7.8%) died. Based on univariate analysis, CRP [odds ratio (OR): 1.25, 95 % confidence interval (CI): 1.1-1.42), LNR (OR: 0.015, 95 % CI: 0.00-0.35), dv-NLR (OR: 510, 95 % CI: 26.7-910), CLR (OR: 710, 95 % CI: 310-210), length of hospitalization (LOH; OR: 1.44, 95 % CI: 1.22-1.63), dyspnea at presentation (OR: 2.83, 95 % CI: 1.23-6.52), and ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO/FiO) on admission (OR: 0.967, 95 % CI: 0.952-0.983) were independent predictors for oxygen requirements. However, the multivariate analysis showed that LNR (OR: 1.686e0, 95 % CI: 6.441e00-0.441), PaO/FiO on admission (OR: 0.965, 95 % CI: 0.941-0.989), and LOH (OR: 1.717, 95 % CI: 1.274-2.314) were the most important predictor for HFNC use. Nasal congestion at presentation (OR: 11.5, 95 % CI: 1.61-82.8) was a unique and independent predictor for ICU admission. As far as death is concerned, the univariate analysis identified elevated CRP (OR: 1.11, 95 % CI: 1.0-1.24), low RT-PCR (OR: 0.829, 95 % CI: 0.688-0.999), high CLR (OR: 3.210, 95 % CI: 5.8-1.8*10), age (OR: 1.08, 95 % CI: 1.02-1.14), body mass index (BMI) over 30 (OR: 5.25, 95 % CI: 1.26-21.96), the chronic use of angiotensin-converting enzyme inhibitors (OR: 5.72, 95 % CI: 1.35-24.09), nitrates (OR: 14.85, 95 % CI: 1.81-121.8), diuretics (OR: 8.21, 95 % CI: 1.97-34.32), PaO/FiO on admission (OR: 0.983, 95 % CI: 0.970-0.998), and nasal congestion at presentation (OR: 9.81, 95 % CI: 1.40-68.68) as independent predictors. However, the multivariate analysis pinpointed that obesity (BMI >30) (OR: 10.498, 95 % CI: 1.107-99.572) remained the most important predictor for death.
LNR and PaO/FiO on admission could be used to timely identify patients requiring HFNC during hospitalization, while obesity (BMI >30) could be an independent predictor of death. Nasal congestion emerges as a unique predictor for ICU admission. HIPPOKRATIA 2022, 26 (2):70-77.
背景/目的：简单的炎症生物标志物，如中性粒细胞与淋巴细胞比值（NLR），可作为2019冠状病毒病（COVID-19）患者的预后指标。本研究旨在探讨入院时炎症生物标志物对重症COVID-19感染患者预后的预测价值。
我们进行了一项回顾性研究，以评估白细胞计数（WBC）、中性粒细胞（N）、淋巴细胞（L）、血小板（PLTs）、C反应蛋白（CRP）、逆转录聚合酶链反应（RT-PCR）、NLR（N/L）、PLR（P/L）、dv（衍生变异）-NLR（N/WBC-L）、LNR（L/N）、dv（衍生变异）-LNR（L/WBC-N）和CLR（CRP/L）在预测2021年4月至9月入住呼吸内科的成年重症COVID-19患者使用高流量鼻导管（HFNC）、入住重症监护病房（ICU）和死亡方面的作用。
共纳入115例患者（60%为男性），平均年龄57.7±16.3岁。37例患者（32.2%）需要升级使用HFNC，8例患者（7%）入住ICU，9例患者（7.8%）死亡。单因素分析显示，CRP[比值比（OR）：1.25，95%置信区间（CI）：1.1-1.42]、LNR（OR：0.015，95%CI：0.00-0.
